Saturday, April 30, 2011

I got up super-early this morning (for me, anyway!) so I could get down to the medlab for my 8am blood draw. It had to be 8am because the cortisol test needed to be done specifically at that time. My GP is investigating why my blood pressure is so low (100/60) especially since he wants me to put me on ace-inhibitor to help save my kidneys - which are misbehaving. I believe that if he finds a problem with the cortisol level it will indicate an adrenal issue, which could be what's causing the low blood pressure. So that could be fixed (one hopes??) and then my ace-inhibitor dosage could be increased to PROTECT ZE KIDNEYS! more. Yup.

Also did the CD3 FSH, LH and Oestradiol hormone tests at the same time, and picked up the huge bottle needed for the 24hr urine test for proteinuria - ITZ ZE KIDNEYS U KNOW!

Saw my aunt in the waiting room. She's just got new kittens! Pixie and Poppy! I can't wait to meet them :D

Oh, and then it was off to work. Last day of office work before the students come back from break on Monday.

I had sent out the grades for the students' first projects yesterday, so I was not surprised to get emails from some students wanting to discuss their grades. Of course, my most troublesome student wanted to meet. And bring her Mum.

I asked the other tutors who were in if they would take a bet on whether she would cry or not. They wouldn't take the bet. I so far have a 3 out of 3 strike rate for crying students at my desk. I go through a LOT of tissues. (Let me clarify: they don't cry cos I'm mean to them, quite the opposite. I try to put realistic pressure on them and they get overwhelmed sometimes. It is very difficult to succeed in a design qualification or career because it's so subjective. The students put a lot of pressure on themselves, and getting a low grade can be crushing for them. I offer all the support and help I can, but you can only lead a horse to water...)

Let's just say it was an emotional meeting, but she left happy.

Kids arrived this evening, but one is working and one is at a Pony Club thing, so it has just been Hubby, Me, and Mister 10 for dinner.

Wednesday, April 27, 2011

I may be in New Zealand, but I am still excited to be involved in America's National Infertility Awareness Week's Bust an Infertility Myth challenge. It's a fantastic campaign to raise awareness for infertility and break apart stereotypes people may have of what infertility is all about. The organisation Resolve.org is the driving force behind the action, and I only wish they had a New Zealand branch!

What is the Infertility Myth that I will bust?

I have chosen to talk about the myths that surround my life, even though they rarely get mentioned out loud.

Myth: Having a sterilisation (i.e. vasectomy) is not true infertility, it's just contraception! What did you expect?

Busted: Actually, that's not true at all. Not. Even. Close.

Let's look at what infertility actually is. The inability to conceive a child after one year of unprotected intercourse (as defined by my doctors and FertilityNZ). And what is a vasectomy? A surgical procedure where the vas (tubes that carry sperm into the seminal fluid) are cut, so that conception will not occur. On the surface, yes it does appear that a vasectomy is indeed a form on contraception. A very effective and (normally) permanent one.

So why am I now classed as an infertile woman?

My husband has a vasectomy. He got it in his previous marriage, and from what he's told me, he did it because with 3 kids already he felt it was the socially responsible thing to do. There may also have been some pressure from the ex-wife too.

We now want kids. I have wanted children for a while. This year we will click over 8 years of infertility. During that time, I have been in as much anguish as any other infertile woman. We may have different underlying causes to our infertility from the majority of other couples, but there is still sweet f*ck all that we can do about it. Without major, expensive medical intervention, of course.

I still desperately want to be pregnant, to give birth, to buy baby clothes for my child and not someone else's, to raise a family with my husband (not just step-kids who very clearly belong to their Mum), and to grow old knowing I will become a grand-mother and have my family line continue.

I remember the shock and hurt I felt when my ob/gyn told me nonchalantly that I was infertile. No I wasn't! I was at his office to discuss getting a vasectomy-reversal for my husband (and more specifically, what I would need to do to get my body ready, as a T1 Diabetic woman) - not to be diagnosed with a new condition!! The shock and disbelief were real. The pain, tears, and anguish are real.

In many blogs I read about IF, women talk about how they hope that their next cycle will be the one, or that next year will be the one, or that this new treatment will work. I feel completely left out, because we are not able to pursue treatment actively at the moment. A vasectomy is 100% effective so it's no use waiting for the next cycle. No amount of (very fun) trying will make a bit of difference.

I see it in people's faces when I reveal that we now want a family. In my parent's surprise, in my friend's careful questions. They are wondering what the hell is wrong with me, wanting to have kids with a (wonderful, loving, handsome, caring, generous, sensitive) man who has a vasectomy! I knew what I was getting into.....didn't I?

Answer: no. I knew that my husband-to-be had a vasectomy, and I vaguely knew that you could get them reversed. But at the beginning of our romance that's about all I knew. I also didn't know that we would fall madly in love and pledge to spend the rest of our lives together in front of our families on Valentine's Day in a heavenly Chinese garden. I didn't know I wanted kids back then when we started dating. And it's not generally something you discuss until the relationship is well and truly "serious".

But once we began investigating the idea of a vasectomy reversal, it soon became clear that it would a) cost a lot, and b) have a very low chance of success. The doctors recommended the big guns for us. What else but infertility would require IVF, ICSI, and sperm retrieval to make a baby?

I was devastated when I found out that I would need to have all the IVF drugs. I did know that IVF was incredibly expensive, and so it was only because we were told that we would "surely" qualify for public funding for fertility treatment that together we went through the infertility workup. Nearly a year passed, with blood tests, ultrasounds, an operation, and consultations, all for naught when we were cruelly denied access to public funding at the last minute. In fact, during the consultation where we were expecting to be given a schedule appointments to kick-start IVF.

I have spent every spare minute over the past year and a half thinking, blogging, emailing, writing, meeting people, and just generally trying to get that heart-crushing decision changed. So far no luck.

But along the way I really hope that I've changed some people's minds about what constitutes infertility. And a sterilisation from a previous relationship certainly counts as infertility. It takes away the couple's right to choose and determine their own life. It brings worry and anguish into the thoughts of the couple, and in our case, it puts the ability to access treatment in the hands of doctors and government officials. How could anyone not be severely affected by this? How could anyone think this is fair? (As the folks who determined the rules do). It has completely changed my life-view. It has made me an advocate for my health and my future.

Believe me, no matter what the cause of your infertility, it will still hurt.

An unwanted sterilisation causes the inability to conceive. This is infertility. It is not able to be changed by the current couple as there is no way to go back in time and alter the decisions made in a previous relationship.

It is my goal to help raise awareness in the New Zealand community about this issue, and I would ultimately love to get the laws around access to public funding for fertility treatment altered so they are no longer discriminatory against couples who have experienced the trauma and suffering of infertility caused by sterilisation from a previous relationship.

I am very pleased that the local eye clinic/hospital has invested in a special anti-diabetic-retinopathy-eye photographing machine, because it means I don't have to have the horrid eye-dilating drops. They sting. They make your eyes sensitive to light (light hurts them), and everything goes blurry so in the past I've had to have a helper drive me home. But no more drops! In and out in under 20 minutes! :)

First day back at work after the hols, and the building was freezing cold. Winter has hit our region with a vengeance. We've had torrential rain and gale force winds for the last 3 days. My cat went mad with the wind and yowled all day and night. Nothing could soothe him, poor thing. There was minor flooding in some places, but the wind! Two trees blown down in my street, and when I got into work today both my colleagues in the office had a big tree down in their gardens too.

I am looking suspiciously at my new fig tree. It has gone from a perfect, perpendicular happy tree, to a slanty, suspicious, "I might fall over, I might not" tree. May have to get out there and tie a rope around it to hold it upright....is that a good idea? I'm not sure...would the tree then just snap?

But winter/autumn is also feijoa season. Yum.

Here in New Zealand, you never buy feijoas. Instead, you wait, until eventually 5 people will offer you a big bag each of fresh feijoas from their trees. "Please take them!" He he he :P I've planted a feijoa tree too, and so far I've eaten 2 fruit off it. I have also stolen many fruit off the neighbour's tree over the back fence as the branches hang low into my vege garden. And I stare wistfully through the fence into the other neighbour's property, where hundreds of feijoas rain down on the dirt and don't get eaten by anyone except the birds. When the sun comes out, and the feijoas on the ground get a bit warm and start to ferment, you can see the birds walking around all tipsy. This is what my cat waits for. :P (Don't worry, he is well fed and only really catches lizards).

I got a bucket load of stuff from the pharmacy last night. Enough bags that the other customers gave me funny looks. Ha.

This is actually a small haul for me, as it's the tail end a the prescriptions from my old GP. And how in hell did anyone think that 2 Lantus pens would last a month? I'm using 690 units per month, and one pen only hold 300 units if you're lucky. Stupid old GP. Can't wait to put in my shiny new prescription from my new GP. :)

Took my first dose of the statin and the ace-inhibitor (to PROTECT ZE KIDNEYS!) last night, and I've not had any way-ward symptoms today.

Oh, and had an insulin disaster *smack forehead* moment when I was packing all the above diabetes-crap away. I found out that 3 vials of my oh so carefully hoarded Humalog actually expired last October. So now my stash is significantly smaller. Although I haven't had the nerve to throw them away yet....better to keep them, just in case.

Tuesday, April 26, 2011

I've just returned from my first ever Diabetes Annual Review (DAR), for free at my new GP's office. Good golly they checked everything. It even included a smear test!

I had a bunch of blood tests a couple of weeks ago, and we discussed the findings in detail. I also got the "tickle test" (where they check you still have sensation in your feet - I was pleased I didn't giggle too much this time), the "read the letters from the chart test" (to check vision), pulses wrist and feet, heartbeat in chest and back, and liver check.

I was passing with flying colours, I even scored a brilliant HbA1c of 6.5% (down again! Yay!)

By the way, if you are a diabetic in New Zealand, or if you know a diabetic in New Zealand, get them to login to TuAnalyze and add their HbA1c data to the map! Look, we only need 12 more NZers to get NZ to light up!

But then came the bad news :(

I have proteinuria, which mean that I spill protein from my kidneys into my urine. Usually, with a diabetic, that is a sure fire sign that your kidneys are on the way out. With me they are not so sure. I had a kidney biopsy way back in '95 (I think??) and the results were inconclusive. Basically they told me that I "might just be one of those people who spill a bit of protein".

Well, with this latest round of blood tests it showed that my kidneys are getting worse. I got a microalbumin of 577, which is waaaaaay to high. All other kidney function tests were failing too. Wah. The GP has duly sent me off to get those big lovely bottles so I can do a 24hr urine collection test. (Translation: you will spend an entire weekend at home collecting pee). He said that if the protein comes in over a certain ratio, then I will have to have another kidney biospy. The biopsy itself was not too bad, but diabetes and me and anaesthetic DO NOT GOT WELL together. :( So everyone please cross your fingers that it's not a high result.

The only thing I can do to protect my kidneys is to take an ace inhibitor, like enalapril or lisonopril. I did try that a couple of years ago, but I stopped taking them after only a couple of weeks due to problems with low blood pressure. The GP couldn't believe it today when he checked my blood pressure and it was lower than before! Now down to 110/60 (and he said that the bottom number needs to be above 60 for efficient blood flow throughout the body or something, i.e. not being dead). So two things will now happen: 1) I get put back on the lowest dose ace inhibitor available, about 1/2 a 2.5mg tablet per day, and I go for another blood test, this one to check my cortisol as it may be affecting my blood pressure and making it go too low.

And the last thing? Yup, even with my good cholesterol (HDL) coming in with excellent numbers, and my ratio of HDL to LDL being great, my LDL is still ever so slightly too high at 2.2 - so he's putting me on a daily statin as well! I am awful at taking pills :( Can never remember them and have lots of trouble swallowing them :( But if it helps prevent me having a heart attack or kidney failure, then it's a good idea to TAKE THE DAMN PILLS ALREADY! (p.s. I'm yelling at myself, not at you, dear reader. Feel free to join in and yell at me to take my pills!)

Today is the last day of my mid-semester holidays and we had torrential rain yesterday and now we have gale force winds. I bought my lunch and drove down to the cliffs overlooking the beach and islands, and got actually very scared when it felt like the wind was going to tip my car into the sea. I reversed back into the hill a bit, and the car stopped rocking about like a aeroplane in turbulence. I ate my custard square looking out over the sea. It was pretty and violent and windy.

Monday, April 25, 2011

I am delighted to receive these blog awards from EBC over at Our New Plan A :D

Thank You!!! :D

They come with a few rules though, so I will do my best to do this right :)

1. Link back to the person who bestowed the awards on you (yup).

2. Tell us 7 things about yourself, for each of the awards (total 14 things):

I'm a web designer and graphic designer by trade, and I currently tutor design at the local institute of technology. It's the best job I've ever had, because it tests my problem solving skills and makes me a better designer. I've got a great bunch of people to work with, and my boss was actually my favourite tutor back when I was studying for my degree!

I live in New Zealand with my husband of 2 years and my cat, Chomsky. Currently, my cat is outside in the back garden stealing the bread I put out for the birds. He doesn't think I can see him :P

I have 3 teenage step kids, and they come to stay with us every second weekend. It's a timeshare arrangement! I have learnt that our house is far too small for 5 people to coexist without killing each other. Our house is still small when they're not here, as their bedrooms are of course still filled with their stuff.

Although I am a designer and an artist, I do not have a studio at home: no room. So that is perhaps why I enjoy web design so much now. Just sit anywhere with a WIFI connection and a power source and my MacBook is good to go.

Last night I made 58 muffins. Today is ANZAC day here in New Zealand and also in Australia. I made the muffins for ANZAC day lunch. We organised for MIL and FIL (who is 83 and frail, uses a walker) to meet us at the parade in town, and we went to collect the 3 sprogs (as it was not our weekend). It's also Easter weekend. The kids have faaaaaaaaar too much chocolate. I was not amused when they demanded to know where our easter eggs for them were. sigh. (Oh, and MIL brought marshmallow cake from the bakery, so everyone wanted to eat that instead. Yay :S )

Hubby and I are infertile as a couple. He has obviously had 3 kids with his ex-wife, and it was also during that marriage when he was persuaded to get a vasectomy. The youngest is now 10yrs, so we know the vas is too old for a good chance at a successful reversal.

I am in the strange position of being an infertile woman (in a couple) who is technically not infertile at all as an individual. I have primary infertility (never had a child) while hubby has secondary (or perhaps is it quarternary infertility, since actually he can't get me pregnant with his fourth?). We've been on this journey for a child now for over 7 years. Our current stumbling block is simple: money. We haz none. We have been denied access to publicly funded fertility treatment (for 3 years) because the NZ government doesn't think that being infertile due to sterilisation is enough to warrant immediate attention. Like it doesn't cause enough emotional pain and suffering or something.... go figure. I won't dwell on this stuff in this post, if you would like to know more, check out the archives on the right >>> :)

My favourite place in the world is with my husband, wherever that may be.

Our favourite place together is probably our little beach hideaway up the coast, where the fishing is ok and the cellphones don't work.

I am addicted to my iPhone.

I credit my iPhone with a 2% drop in my HbA1c test results. How? I got an app called "Insulin Calculator", which mimics the bolus wizard on an insulin pump.

Oh yep, I am Type 1 Diabetic, on Multiple Daily Injections of Humalog and Lantus. This year will be my 23rd anniversary of diagnosis.

The house I live in used to belong to my Grandmother. The walnut tree that I'm looking at originally came from her mother's place further up North. So that walnut tree is my link to my Great-Great-Grandmother. It makes seedlings all over the place, so plenty of my family members have got walnut trees growing all around the province now :)

And one for luck: Went to the dentist (finally, after 3 years!) and he wants to book me for 3 more appointments, and a trip to see an orthodontist. Someone asked me the other day how much it will cost. I said "All of it!" :P

3. Award other bloggers

The Versatile Blogger award is supposed to go to 15 "recently discovered bloggers" and the Stylish Blogger award is supposed to go to 10 - 15 blogs "you feel deserve this award".

If you find your name below, I have given you both! (but you can just do one if you like, or none even! Your choice.)

Friday, April 22, 2011

I had phoned my GP's nurse to put in a request for more diabetes supplies, and at the same time asked if I could re-do the fertility-hormone blood tests. I just wanted to check and make sure nothings changed. She was really helpful "no worries!".

So today is 21st April, which is coincidentally also my CD21, which means it's time to get my progesterone (and HbA1c and Complete Blood Count) blood draw done. I think I will wait until I've got the remainder of the hormone tests done.

One near-snafu is that the remaining blood tests have to be done on CD3, which currenlty looks like it will fall on a Sunday. When the lab is closed. Dumb.

Tuesday, April 19, 2011

This is quite obviously a guy's ute. It has business branding all over it. Check out the number plate:

I know right? What were they thinking?? :P lol

In less trite news, I am now on holiday. I get ten days for mid-semester break - no students, no lesson plan, no meeting, no....dishwasher? Unfortunately yes, it be broken :( it takes our family exactly 2 days to use all the dishes we own.

So I've been doing a lot of house work, cleaning, loads of laundry.

And I like me new GPs office very much. Got a call from one of the nurses today about a discrepancy in my notes. She was super cool to talk to about sorting out a whole lot of blood work tests I need to get done, and getting a serial card so I can have an HbA1c whenever I want (read: remember).

She was also happy to add tests for fertility hormones, just because I want to be proactive and you know, know that stuff and not be surprised with it at any stage.

The nurse I spoke to is also really interested in diabetes, both types, and she encouraged me to come along for a free diabetes check. My old GP didn't make much of a case for this check, but my new GPs office is really into it. She explained that it will cover more than what my diabetes care team looks at, such as blood pressure, full blood work, feet, eyes etc. Hey, it's a free full physical. And I'm on holidays. What's not to like?

Oh yeah, the vampires. Had to get bloodwork done before I can have the check. Bah. Dislike.

BTW, it is not advisable to have a blood draw after you've just exercised for 30 mins and have a blood test of 4.7mmol/L. Causes near-fainting in the phlemotomist's chair. Lol

Ooh and the best bit! I still haven't told you the best bit: when I was on the phone to the nurse she got my new prescription for insulin et al. sorted out.

"How many vials do you normally get?" she asked.

"Um, my last doc just wanted to know how many units per day I use, and he would work it out. But it meant I never had enough to last me through the 3 months because I do a 1- 2 unit air-shot to get rid of bubbles."

"OK, we'll give you 5 vials of each Lantus and Humalog, and see if that's enough"

"*smile*" that's going to be 30 vials of insulin over 3 months!!! How awesome is that! I loooooove having backup supplies in the fridge. This means I could also put some spares at work too. How wonderful :)

(non-diabetic readers will probably wonder why I'm getting so excited over a prescription. Well it means that I will have an adequate backup supply of my absolutely essential insulin. It also means that my new doctor's office understands this and is willing to be flexible and helpful)

Saturday, April 9, 2011

Hubby and I have just returned from a 25th wedding anniversary party of a good friend of his. In fact, hubby was one of their groomsmen. 25 years ago I was 3 going on 4. My sister was only a month old.

I had a lot of trouble at the party, and not just my normal issues where I feel uncomfortable because I'm not drinking, don't know what to say, don't know anyone there, or am a good 20 years younger than everyone.

No, tonight was hard work because they were celebrating their 25th wedding anniversary. And I don't know if we will. After 25 years they have 3 kids, a fabulous home etc etc, and I don't know if we will have any of that. I hate when our age difference gets thrown in my face like that :(

Note: hubby and I love each other very much, and we had a big hug and agreed that neither of us had particularly enjoyed the party and the speeches, but it seems for different reasons. Oh well. Life goes on.

Another note: turns out I am rather low. 3.7mmol/L. May explain the randomness of this post a bit. Today has been odd, food-wise. Woke late at about 11am, and Hubby made breakfast in bed: bacon, eggs, salad, toast. Yum. But a strange-late breakfast combined with a new insulin-carb ratio meant my day has been tough to manage. Blood-sugars = random. Then we completely missed lunch because we were trying to set up a new modem. MUST. HAVE. INTERWEBS! And of course, dinner at the party tonight. I got to try smoked Marlin. Very tasty, but no carbs in fish. Plus some stress, plus walking to and from the party = low.

Anothernother note: it has taken me 2.5 hrs and 1 James Bond movie ("Die another day"? "Never say die"? "Never say die another day?") on late night telly to write this :P

Thursday, April 7, 2011

I am so glad I changed GPs. My new GP was quite happy to spend an hour chatting about diabetes and IVF, and he was very interested in my experiences as an adult diabetic with Type 1.

It's fantastic to have stable, positive GP care again. I've missed that. My last GP went nutso. And then his receptionist went nutso too. Yeah so after more than 6 months of inadequate care from my old doc, I finally have a primary care doctor who I feel I can trust. (Oh, and the nurse-receptionist gave me a flu shot, which has hurt like billy-oh for 3 days now :( wah)

Yep, so that's a load off! :)

I also went along for a very quick appointment to my diabetes nurse educator. Even with a bunch of builders and electricians in the office (some hospital renovation disaster) she was still able to spot the cause of a trend that I haven't been able to figure out. I keep waking up either on target or a bit low, then going high coming into lunch, often having a low at around the 4pm mark, and then just getting really crazy wild variable results at dinner.

She explained that if I increase my insulin to carb ratio for breakfast, from 1:14 to 1:12, this would give me a slightly larger breakfast dose of Humalog, which would help prevent the highs at lunchtime. Having a more normal lunchtime test would mean I don't over-treat the lunchtime dose, which will in-turn help prevent dose stacking and 4pm lows. No 4pm lows will mean a more stable dinner test result. Well, that's the plan. I will give it a crack :)

Oh yeah, I've also finally gotten around to it, and booked an appointment with my dentist. It's only been like, what, 3 years!! :P

As you have probably guessed, I have a sore tooth. Not too bad, but enough to make me pick up the phone and call. It will probably hurt my bank balance more than it hurts my jaw.

My GP, just to hop back a few topics, was interested in our struggles to get funding for IVF, and interestingly enough he got to talking about doctors he had trained with. Turns out the chief of Fertility Associates was in his class at medical school. So he's suggested I write a letter to him directly.

Yes, you have heard me say that "I will write letters" before. And you know that it takes me bloody ages to get around to actually doing it. That's because life makes me tired, teaching makes me tired, diabetes makes me tired, thinking about IF makes me tired, and getting the strength to sit and write a coherent and convincing letter, which I know will in all probability only result in a polite form letter or brush-off, is hard. It's hard enough just to think about it, let alone turn the events of the last year and a half over in my head without breaking down into a sobbing mess.

But I have to make time to write the following letters:

Complaint letter to CEO of Fertility Associates

Letter requesting review of our case, with special consideration of our unusual case, to head of the local district health board

Perhaps a letter directly to the Minister of Health, as he didn't truly "get it" when my local MP contacted him. In fact, he completely missed the point.

Yep, I will get there eventually. Surely, sooner or later, someone in a position powerful enough to fix this mess will see that logic has just escaped the building when they decided to discount the medical facts.

Work has been a bit manic, with all my students preparing to submit their first design projects this week. Oh the craziness and tears and wailing and "I can't do this" (them, not me) and "I've lost my design mojo"! Ha! It's great! :P It's the time when my students finally figure out that what I've been teaching them is actually useful, and if they are one of the students who pay attention and put in the hard slog, then presentation day is a blissful relief. Of course, it's always the 20% of students who cry and wail and stamp their little feet which make it all so exciting. Getting them across the line is all part of the challenge. I get to be a design tutor, a counsellor, a life coach, and a technical help line all in one. And I love it. I love figuring out what makes them act the way they do, and how I can best use that knowledge to help them learn. But by jove is it tiring. I tell all my students I am on call 24/7 (whether I answer then is another matter :P ) but most of them are taking me up on the offer, and actually coming out of their teenage shells and COMMUNICATING with me, which is fantastic! :)

Easter is coming up, and I got in early and bought a bunch of yummy chocolate eggs for the step-kids. Goddamn! 3 teenage kids can eat a lot! But they haven't found where I've stashed them yet. I don't think...better go check!

p.s. sorry I've not posted as often as I normally do - we've had some severe interweb connectivity issues :(

About Kaitake

I'm a type 1 diabetic woman living in New Zealand. I'm recording my experiences in deciding to have a baby with my husband, and our journey through doctor's visits, procedures, vasectomy reversal, sperm retrieval, ivf, icsi, and (hopefully) pregnancy and birth. Comments and feedback most welcome.